Provider Demographics
NPI:1336184001
Name:WILL VISION AND LASER CENTERS, P.S.
Entity Type:Organization
Organization Name:WILL VISION AND LASER CENTERS, P.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:R
Authorized Official - Last Name:WILL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:360-885-1327
Mailing Address - Street 1:8100 NE PARKWAY DR
Mailing Address - Street 2:SUITE #125
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98662-6742
Mailing Address - Country:US
Mailing Address - Phone:360-885-1327
Mailing Address - Fax:360-449-0392
Practice Address - Street 1:8100 NE PARKWAY DR
Practice Address - Street 2:SUITE #125
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98662-6742
Practice Address - Country:US
Practice Address - Phone:360-885-1327
Practice Address - Fax:360-449-0392
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00026277207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty